The Role of Structure in the Assessment of Psychopathology

Abstract

Summary: This study investigated the role that the structure of a diagnostic instrument plays in the assessment of personality functioning. Empirical studies have shown that the cards of the Rorschach and Holtzman Inkblot Technique (HIT) vary significantly with regard to their structure. Thus, it was possible to investigate if cards of high vs. low structure tend to elicit specific diagnostically useful responses. For this purpose, samples of normals (n = 30), patients with neurotic disorders (n = 30), borderline patients (n = 30), acute schizophrenics (n = 25), and chronic schizophrenics (n = 25) were studied with the HIT. For each diagnostic group it was examined if cards of high vs. low structure tended to elicit more thought disordered responses, hostility, and anxiety according to the HIT scoring system. With regard to structure, two aspects were differentiated, structural vs. interpretative ambiguity of the HIT cards. In all nonschizophrenic groups, cards of high structural ambiguity elicited significantly less thought disordered responses. By contrast, cards of high interpretative ambiguity elicited more thought disordered responses, anxiety, and hostility in all groups except the chronic schizophrenics. The measures of structural vs. interpretative ambiguity of the HIT cards showed a negative correlation in all diagnostic groups. According to these results, both aspects of ambiguity and their interplay play an important role in the assessment of psychopathology, at least within the range of ambiguity represented by the inkblots of the HIT.